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NPI Code Detail

MEDICARE: DR. KEITH FERRARI LASKO MD

MEDICARE: DR. KEITH FERRARI LASKO MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician187588CA

General Provider Information

NPI Number : 1225659907
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEITH FERRARI LASKO MD
Provider Business Mailing Address
First Line : 5 BURNETT AVE N APT 5
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94131-3320
Country : US
Telephone Number : 702-630-4927
Fax Number :
Provider Business Practice Location Address
First Line : 1900 SULLIVAN AVE
Second Line :
City : DALY CITY
State : CA
Zip : 94015-2229
Country : US
Telephone Number : 650-992-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2020
Last Update Date : 12/03/2024

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